Does insurance cover colonoscopies?

Getting a regular colonoscopy screening is one of the best ways to help prevent colorectal cancer.

Preventive care screenings

A colonoscopy is a procedure that use a flexible, camera-equipped tube to examine the colon and rectum for abnormal tissue growths called "polyps," colorectal cancer, and other digestive disorders. It helps in early cancer detection, improving treatment success, and supporting preventive care efforts.

Under the Affordable Care Act, Medicare and insurance companies cover the costs of screening colonoscopies for patients 45 years old or older. This important screening tool could help save your life.

Screening Information for Women

Screening Information for Men

Coverage for colonoscopies

Colonoscopies are a type of preventive care that costs little to nothing, depending on your insurance plan. However, additional costs may apply if polyps are removed or biopsies are taken during the procedure.

You may also pay out-of-pocket costs if the colonoscopy is a follow-up to unusual results or as an initial exam due to symptoms.

Before you have a colonoscopy, you should confirm your coverage details. Some members without full insurance coverage may qualify for financial assistance programs or other screening options.

Consult with a doctor to determine the right screening schedule based on your age and health history.

Learn about colon cancer risk factors

What to expect as a colonoscopy patient

Before

Before your appointment, you'll need to prepare your digestive system. Your doctor will give you specific instructions, including dietary restrictions, to prepare. They will also likely recommend a laxative to ensure your system is fully cleared.

During

Most colonoscopies take 30 minutes to an hour.

Patients often receive a sedative immediately before the colonoscopy. You'll lie on your side on the exam table. If necessary, they will introduce air, water, or carbon dioxide into your colon.

After

After the exam, most people need 30-60 minutes to recover from the sedative, but its effects can last up to a day. You'll need someone else to drive you home safely.

You'll usually receive the results either immediately after the procedure or within a few days. If polyps or other issues are detected, they will discuss next steps with you.

Take the confusion out of insurance

Our Knowledge Center features helpful articles with simple and reliable information for all your insurance questions, from how to submit a claim to how to find the right doctor.

Preventive care basics

Preventive care is routine health care that helps prevent health problems. Think flu shots, cancer screenings, and blood pressure checks.

Where to go for care

Knowing where to go when you have a health scare is vital to getting the care you need, when you need it. It can also save you time and money.

What is a deductible?

Learn about health insurance deductibles so you can plan your health expenses in advance.

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